A New Mexico Telehealth Alliance, Southwest Telehealth Resource Center, & HealthInno NM Collaboration

​INNOVATING REMOTE ACCESS TO CARE

A special extended event starting with educational presentations from national and regional experts, followed by Table Talks for networking and small-group discussions, and ending with an open mic session for in-person attendees to introduce themselves and their work, and to announce upcoming events, accomplishments, and collaborative opportunities. The recorded educational presentations linked below focus on trends and updates in remote care delivery, telehealth adoption, regulation, and local efforts to expand innovative approaches to remote access to health care.​​

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AGENDA​

 

• Kick-off, Welcome, Event Partner Introductions​ 

• Opening Remarks

• ​Bridging Health Equity Gaps / Disparities

• AI + Digital Innovation

• Medicare Telehealth

• HCA/Turquoise Care Vision & Strategies

• Closing, State Legislature Remarks

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​​​PRESENTATION RECORDINGS, SLIDE DECKS, & SUMMARIES:

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• Kick-off with Event Welcome + Introducing Partner 

  • Stefany Goradia​, MEIE (LinkedIn)

    • Head of Impact + Community, HealthTech Rx​

  • Stetson Berg, MPH (LinkedIn)

    • Board Chair, New Mexico Telehealth Alliance

  • Alex Carter, PA-C (LinkedIn)​

    • Board Vice Chair, New Mexico Telehealth Alliance​

  • Video Key Points & Highlights

    • Stefany Goradia: Overview of HealthTech RX's mission and event goals

      • Networking and Participation:

        • In person attendees encouraged to network and rotate through 4 Table Talks on diverse healthcare topics.

        • No scheduled breaks; food served and cash bar served opens at 5 PM.

      • Focus Areas:

        • Enhancing care delivery for rural and underserved communities.

        • Exploring partnerships and innovation in digital health solutions.

      • Event Structure:

        • First Half: Educational presentations by local/national experts on trends and regulations (2–5 PM).

        • Second Half: Interactive Table Talks focusing on specific topics (5–7:30 PM).

      • HealthTech RX Role:

        • Functions as innovation hub and convenes stakeholders for collaborative problem-solving.

        • Organizes quarterly events, innovation challenges, hackathons, and pilot programs to address unique healthcare challenges.

      • Event Overview:

        • Q4 HealthInno NM event by HealthTech RX, focusing on healthcare innovation in New Mexico.

        • Aims to bring together healthcare leaders, technologists, policymakers, and stakeholders to improve health equity and economic development.

        • Theme: "Rethinking Remote Care," emphasizing telehealth and tech-enabled care models for underserved communities.

    • Stetson Berg: Telemedicine advancements and local/national scale innovation

    • Alex Carter: Personal and professional insights on telehealth​

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• Opening Remarks 

  • Elizabeth Krupinski, PhD (LinkedIn)
    • Professor & Vice-Chair for Research, Dept. of Radiology & Imaging Sciences, Emory University
    • Associate Director of Evaluation, Arizona Telemedicine Program
    • Director, Southwest Telehealth Resource Center
  • Video Key Points & Highlights​

    • Southwest Telehealth Resource Center:

      • Focuses on promoting and supporting telehealth in Four Corners region and Nevada.

      • Aims to expand, start, or improve telehealth programs through training, grant support, and resource sharing.

    • Mission and Goals:

      • Enhance patient care and accessibility using telehealth.

      • Overcome challenges and advocate for telehealth adoption as a standard care tool.

    • Historical Collaboration:

      • Participated in Four Corners Telehealth Consortium, connecting states in the region.

      • Involved in telehealth and digital health initiatives since the mid-1990s, including partnerships in New Mexico.

    • Future of Telehealth:

      • Envisions telehealth as a standard tool for quality care rather than a distinct service.

      • Strives for seamless integration of telemedicine and digital health in healthcare practices.

    • Event Contribution:

      • Supporting educational talks and roundtables to share knowledge and resources.

      • Encourages attendees to adopt telemedicine and digital health practices to improve care delivery.

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• Telehealth: Bridging Health Equity Gaps or Widening Disparities? 

  • Michael Holcomb, BS-MIS (LinkedIn)

    • Associate Director for Information Technology, Arizona Telemedicine Program

    • Interim Director, Southwest Telehealth Resource Center  

  • Carrie Foote, BS, BA (LinkedIn)

    • Program Administrator, Southwest Telehealth Resource Center

  • Video Key Points & Highlights

    • Modalities:

      • Synchronous care

      • Asynchronous care

      • Mobile health

      • Remote patient monitoring

    • Requirements:

      • Service availability

      • Broadband internet connection

      • Patient/caregiver Literacy

      • Telehealth compatible technology

      • Patient assistance/accommodations

      • Funding Sources

      • Patient consent

      • Privacy and HIPAA

    • Benefits:

      • Promotes equity by addressing barriers to healthcare access

      • Dismantles geographic constraints

      • Eliminates transportation obstacles

      • Promotes ongoing care for chronic conditions/improves chronic disease management

      • Provides access to specialists

      • Increases access for underserved populations

      • Addresses healthcare professional shortages and healthcare deserts

    • Challenges:

      • Digital divide

      • Language/cultural barriers

      • Digital and health literacy

      • Differential adoption rates

      • Technology comfort level

      • Lack of private space

      • Lack of accommodation for disabilities

      • Telehealth as sole access point

      • Economic barriers

      • Policy barriers

      • Lack of continuity of care

    • Rates of use:     

      • High:

        • 73% - young adults 18-24

        • 69% - earn $100k/year

        • 66% - private insurance

        • 62% - white

      • Low:

        • 38% - no high school diploma

        • 44% - older adults >65

        • 51% - Latino and Asian

        • 54% - black

      • Disproportionally impacted by digital divide:

        • Elderly

        • Racial/ethnic minorities

        • Disabled

        • Low-income

        • Rural

        • Limited English proficiency

      • Inherent biases in some technologies

    • Solutions for equitable access:

      • Provider education

      • Assessing patient readiness

      • Infrastructure expansion (broadband)

      • Digital health literacy

      • Telehealth access points

      • Telehealth in libraries

      • Partnerships and leadership

      • Evidence-based solutions

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• AI + Digital Innovation in Healthcare ​

  • Elizabeth Krupinski, PhD (LinkedIn)

    • Professor & Vice-Chair, Research Dept. of Radiology & Imaging Sciences, Emory University

    • Associate Director of Evaluation, Arizona Telemedicine Program

    • Director, Southwest Telehealth Resource Center

  • Video Key Points & Highlights​
    • ​​Background:

      • Expert in medical imaging, AI, and human-computer interaction

      • Leadership roles in telemedicine and imaging societies

    • AI in Healthcare:

      • AI is transforming healthcare through predictive analytics, ambient clinical intelligence, and wearable technology.

      • 64% of U.S. hospital systems already use AI, primarily for sepsis prediction, reducing hospital readmissions, and improving efficiency.

    • Key AI Applications:

      • Predictive Models: Identifying risks like sepsis and patient decompensation.

      • Ambient Clinical Intelligence: Automatically documenting clinical interactions to save time and improve patient-provider communication.

      • Wearables: Devices like sensors in clothing and rings to monitor health metrics and predict adverse events.

      • Embodied AI: Robotics for tasks like patient transport, medication delivery, and remote communication.

    • Challenges in AI Adoption:

      • Bias: AI often reflects biases in training datasets, leading to inaccuracies in diverse populations.

      • Transparency: Many AI tools lack the ability to explain their decisions, hindering clinical trust and utility.

      • Regulation: Limited FDA oversight of AI tools creates potential risks in their clinical use.

      • Data Quality: Poor data and limited external validation can reduce AI effectiveness.

      • Deskilling: Over-reliance on AI could hinder skill development in healthcare professionals.

    • Ethical and Practical Considerations:

      • Addressing privacy concerns in ambient listening technologies.

      • Balancing the use of AI with human judgment to prevent cognitive biases and over-reliance.

      • Developing explainable AI to enhance clinical decision-making.

    • Future Potential:

      • AI-enabled tools for automating repetitive tasks, improving workflows, and enhancing diagnostics.

      • Integration of advanced biometrics to detect conditions like depression, anxiety, or autism using subtle cues like voice or eye movement.

      • Opportunities to improve healthcare equity by addressing systemic biases in healthcare algorithms.

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• Medicare Telehealth: How to Plan Patient Care During Uncertainty 

  • Carol Yarbrough, MBA-TM (LinkedIn)

    • Business Operations Manager, Telehealth Resource Center, UCSF Medical Center

  • Video Key Points & Highlights

    • Background:

      • Specialization in healthcare compliance, reimbursement, and telehealth policy.

      • Offers guidance on billing, coding, and regulatory compliance for telehealth services.

    • Medicare Telehealth Evolution:

      • Telehealth policy began with Social Security Act (2001), limiting originating sites and eligible providers.

      • During the COVID-19 public health emergency, telehealth services were expanded significantly.

    • Policy Changes and Uncertainty:

      • Public health emergency waivers allowing broad telehealth access are set to expire.

      • Congress and CMS are deliberating future policies, with potential extensions being debated.

      • DEA policies on telehealth prescriptions, especially controlled substances, remain unresolved.

    • Current Telehealth Codes:

      • Medicare supports 268 telehealth CPT codes; some are provisional and may be removed.

      • Behavioral health services retain strong telehealth support, including Audio-Only services (with limitations).

    • Indigenous Health Telehealth Initiative:

      • New federal funding supports telehealth access for indigenous communities in pilot states (e.g., California, Oregon, New Mexico).

    • Practice Management Insights:

      • Clinics should prepare for potential policy changes by documenting telehealth utilization and exploring asynchronous care options.

      • Consider workflow optimizations to balance telehealth and in-person care.

    • Legislative Advocacy:

      • Stakeholders are encouraged to engage with legislators to support permanent telehealth policies.

      • Advocacy is particularly crucial for urban areas where telehealth services might be curtailed.

    • Future Outlook:

      • CMS might provide short-term extensions while working on long-term solutions.

      • New opportunities include caregiver training via telehealth and innovative uses for asynchronous care.

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• HCA/Turquoise Care Vision + Strategies for Expanding Remote/Access to Care 

  • Alexandria Castillo Smith, MPH, MSW (LinkedIn)

    • Deputy Cabinet Secretary, NM Healthcare Authority

  • Video Key Points & Highlights​

    • Overview of Turquoise Care (TC) Goals

      • Goal 1 – Build a NM healthcare delivery system that is accessible for both preventive and emergency care that supports the whole person (PH, BH, SDOH).

      • Goal 2 – Strengthen the NM healthcare delivery system through expansions and implementation of innovative payment reforms and VBC initiatives.

      • Goal 3 – Identify groups that have been historically and intentionally disenfranchised and address health disparities through strategic program changes to enable an equitable chance at living healthy lives.

    • TC Health Plans

      • Blue Cross Blue Shield of NM

      • Molina Healthcare

      • Presbyterian Turquoise Care

      • United Healthcare Community Plan

    • New TC Benefits

      • New Home Visiting Program for New Mothers

      • Reimbursement for Community Health Workers

      • Chiropractic Services

      • Continuous coverage for children up to age 6

    • Changes to Telemedicine During Covid-19

      • Promoted access to video and phone telehealth services

      • Expanded proportion of members in rural and urban areas that were able to access care

    • HCA Approach to Telemedicine: TC Contract Requirements

      • Quarterly Telemedicine Report to HCA from MCOs

      • Audiovisual asynchronous, remote monitoring

      • Training for providers of appropriate services for telemedicine

      • Targets set to increase telemedicine usage by 20% or be penalized.

    • NM Medicaid Telemedicine Services

      • Telemedicine

        • Must include audio and visual

        • Be delivered real-time a the originating and distant site

        • No restrictions on services that can be offered via telehealth

        • If provider resides outside of NM they must be licensed in NM

      • Telephone

        • Able to reimburse for all telephonic visits covered during the Public Health Emergency

        • After 12/31/2024 will follow the codes that are permitted by Medicare, primarily BH codes.

    • Project ECHO

      • Have hubs of virtual learning opportunities on a wide variety of topics for providers

      • MCOs support Project ECHO and encourage utilization

      • Collaborates with Indian Health Services

      • Have a unique relationship with Medicaid Program

      • MCOs identify members who would benefit from Project ECHO

    • MCO Support for Advancing Telemedicine

      • Providing access to high-speed internet for rural communities

      • Bring in new providers that focus on telehealth services and specialties

      • Scholarships to health professionals

      • Grants to physician practices to keep providers in NM

    • Tribal Communities’ Health Care Priorities

      • Native American Technical Advisory Committee – 13 Tribes represented

      • Goals include:

        • Increase BH services for Native Americans

        • Increase Medicaid reimbursable provider types and services for HIS and Tribal clinics

        • Increase the number of long-term care options

        • Increase NA enrollment in Medicaid

    • Rebuilding Behavioral Health in NM

      • Received CMS federal approval to begin to provide Medicaid coverage to those exiting incarceration up to 90-before release

      • Raising BH Medicaid reimbursement rates up to 150% of Medicare rates

      • 6 Certified Community BH Clinics (CCBHCs) slated to launch in 2025

      • Support for pregnant members with Substance Use Disorder

      • Added 5 new BH Practices for enhanced rates, encouraging more providers to expand their services

    • Rural Health Care Delivery Fund

      • $80 Million in funding available to rural health care providers

      • Expansion and delivery of new services in rural communities, including telehealth services

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• NM Telehealth Alliance, NM State Telehealth Law, and Closing Remarks 

  • ​Stetson Berg, MHA (LinkedIn)

    • Board Chair, New Mexico Telehealth Alliance​

  • Video Key Points & Highlights​

    • New Mexico Telehealth Alliance (NMTA):

      • Established in late 1990s to advocate for and advance telehealth in New Mexico.

      • Focuses on policy, legislation, and connecting stakeholders to solve telehealth challenges.

    • Telehealth Law in New Mexico:

      • Among the most progressive in the U.S., enabling telehealth billing parity for audio, video, asynchronous, and remote patient monitoring services.

      • State law allows billing for phone visits, as clarified in 2022 "audio only" update.

      • Applies to fully insured health plans under NM Office of Insurance and specific public health plans, but not Medicaid, Medicare, or self-insured plans.

    • Legislation and Advocacy:

      • NMTHA worked with legislators to craft state-friendly telemedicine policies before the pandemic.

      • Advocating for expanded reimbursement models to ensure telemedicine services are financially sustainable for providers and facilities.

    • Resources and Collaboration:

      • Offers webinars, online resources, and direct problem-solving for billing, policy issues, and other telehealth barriers.

      • Collaborates with federally funded organizations like Southwest Telehealth Resource Center for expertise and solutions.

    • Reimbursement Challenges:

      • Payment parity exists but often doesn't cover operational costs for telehealth services, especially in rural settings (e.g., financial strain on providers/facilities delivering telemedicine with insufficient reimbursement).

    • Interstate Practice Issues:

      • Licensure laws vary by state, complicating cross-border care for established patients.

      • Efforts to create interstate compacts for streamlined licensure are ongoing but involve significant paperwork and limitations.

    • Call for Feedback and Participation:

      • NMTHA encourages stakeholders to share telehealth challenges and ideas to inform future legislative and operational improvements.​​​​​​​​

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